Evaluating Ten Second Triage: A Novel Multi-Agency Prehospital Triage Tool for Major Incidents

Abstract

This article is an example of ‘Lessons from the Field’. Recent inquests following major incidents in the United Kingdom have criticised the ‘care gap’—the time period between an incident occurring and emergency services accessing casualties to deliver life-saving interventions. To address this, Ten Second Triage (TST) was developed in the United Kingdom to facilitate rapid non-physiological assessments by any first responder, regardless of their profession or organisation. TST aims to speed up the delivery of early life-saving interventions and facilitate the prioritisation of casualties, ultimately improving casualty outcomes in major incidents. The current study evaluated TST's usability through a series of live exercises involving the participation of specialist and non-specialist responders from a variety of Police, Fire and Rescue, and Ambulance Services in the United Kingdom. Focus groups and questionnaires were used to capture participants' perceptions of TST and their experiences using it during the exercises. Results show that TST can be used to facilitate the delivery of early life-saving interventions and casualty prioritisation by responders regardless of their clinical background, and that responders from all services are confident in using it. However, results also highlighted key considerations for the practicalities of using a multi-agency triage tool, such as TST, in real emergencies including the consideration of key interoperability factors, such as communication, the importance of reciprocal trust, and collaborative training. Recommendations drawn from this evaluation informed the further development of TST and supported its integration into UK practice in Spring 2023.